When two eminent and experienced pathologists hold what appear to bediametrically opposed views on the specificity of the histological features of hypertrophic cardiomyopathy is is hardly surprising that clinicians are confused. This confusion has occurred as a result of the articles by Becker and Caruso'and Maron. 2 Stated simply the opposing views held by these wor-kers are, on the one hand, that myocardial disarray is the pathognomonic feature of hypertrophic car-diomyopathy and, on the other, that since it can occur in normal hearts the specificity must be seriously questioned.

When such divergent views are held it is natural to look for further opinions from within the ranks of those concerned with tissue morphology who have equal experience of the condition in question. The hospital department in which Teare worked and from which came the first description3 of asymmetrical hypertrophy must surely fit this specification; moreover, the department has continued to see numerous cases both from hospital and forensic nec-ropsies. Teare originally stressed two salient features of hypertrophic cardiomyopathy3; firstly, the asymmetry of the septal hypertrophy and, secondly, the bizarre and disorganised arrangement of the muscle bundles in the ventricular septum. The absolute specificity of asymmetrical septal hypertrophy was questioned soon after his initial description, but only with the advent of echocardiography was it generally realised that only some patients with hypertrophic cardiomyopathy have disproportionate septal hypertrophy and conversely that a degree of asymmetry is found in severe left ventricular hypertrophy from whatever cause. In retrospect it is interesting that, of the eight original specimens from Teare's work extant, in only five is the left ventricle actually asym-